The association between obesity and severe disability among adults aged 50 or over in nine high-income, middle-income and low-income countries: a cross-sectional study.

Journal: BMJ open

Volume: 5

Issue: 4

Year of Publication: 2015

Affiliated Institutions:  Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain. Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigacions Biomédiques Sant Pau (IIB Sant Pau), Sant Antoni Maria Claret , Barcelona, Universitat Autónoma de Barcelona, Bellaterra (Cerdanyola del Vallés), Spain. Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain. Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland. Department of Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy. National Institute for Health and Welfare, Helsinki, Finland. Department of Epidemiology, Jagiellonian University Medical College, Krakow, Poland.

Abstract summary 

The association between obesity and disability may differ between high-income and low-income/middle-income countries but there are no studies comparing this association between these settings. The aim of the study was to assess this association in nine countries using nationally-representative data from the Collaborative Research on Ageing in Europe (COURAGE) study and the WHO's Study on global AGEing and Adult Health (SAGE).Population-based cross-sectional studyThe survey was conducted in China, Finland, Ghana, India, Mexico, Poland, Russia, South Africa and Spain between 2007 and 2012.42 116 individuals 50 years and older. The institutionalised and those with limited cognition were excluded.Disability was defined as severe or extreme difficulty in conducting at least one of six types of basic activities of daily living (ADL).The mean body mass index (BMI) ranged from 20.4 kg/m(2) in India to 30.7 kg/m(2) in South Africa. Compared to normal BMI (18.5-24.9 kg/m(2)), BMI≥35 kg/m(2) was associated with significantly higher odds for ADL disability in Finland (OR 4.64), Poland (OR 2.77), South Africa (OR 2.19) and Spain (OR 2.42). Interaction analysis showed that obese individuals in high-income countries were more likely to have ADL limitations than those in low-income or middle-income countries.The higher odds for disability among obese individuals in high-income countries may imply longer life lived with disability due to factors such as the decline in cardiovascular disease mortality. In South Africa, this may have been due to the exceptionally high prevalence of class III obesity. These findings underscore the importance of obesity prevention to reduce the disability burden among older adults.

Authors & Co-authors:  Koyanagi Ai A Moneta Maria Victoria MV Garin Noe N Olaya Beatriz B Ayuso-Mateos Jose Luis JL Chatterji Somnath S Leonardi Matilde M Sainio Päivi P Galas Aleksander A Haro Josep Maria JM

Study Outcome 

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Citations :  Swinburn BA, Sacks G, Hall KD et al. . The global obesity pandemic: shaped by global drivers and local environments. Lancet 2011;378:804–14. 10.1016/S0140-6736(11)60813-1
Authors :  10
Identifiers
Doi : e007313
SSN : 2044-6055
Study Population
Male,Female
Mesh Terms
Activities of Daily Living
Other Terms
EPIDEMIOLOGY;NUTRITION & DIETETICS;PUBLIC HEALTH
Study Design
Cross Sectional Study
Study Approach
Country of Study
Ghana
Publication Country
England